骨骼肌指数对肝细胞癌患者经TACE后预后的影响  

Impact of skeletal muscle index for prognosis of hepatocellular carcinoma patients after TACE

作　　者：王晓娟 李金龙 王继涛 王文川 孟令雷 高凤霄 WANG Xiaojuan;LI Jinlong;WANG Jitao;WANG Wenchuan;MENG Linglei;GAO Fengxiao(Department of CT/MRI,Xingtai People’s Hospital Affiliated to Hebei Medical University,Xingtai 054000,China;Hebei Key Laboratory of Liver Cirrhosis Portal Hypertension,Xingtai 054000,China;Department of Laboratory,Xingtai People’s Hospital Affiliated to Hebei Medical University,Xingtai 054000,China;Department of Hepatobiliary Surgery,Xingtai People’s Hospital Affiliated to Hebei Medical University,Xingtai 054000,China;Department of Hepatology of Integrated Traditional and Western Medicine,Xingtai People’s Hospital Affiliated to Hebei Medical University,Xingtai 054000,China)

机构地区：[1]河北医科大学附属邢台市人民医院CT/MRI科,河北邢台054000 [2]河北省肝硬化门静脉高压重点实验室,河北邢台054000 [3]河北医科大学附属邢台市人民医院检验科,河北邢台054000 [4]河北医科大学附属邢台市人民医院肝胆外科,河北邢台054000 [5]河北医科大学附属邢台市人民医院中西医结合肝病科,河北邢台054000

出　　处：《中国介入影像与治疗学》2024年第4期201-205,共5页Chinese Journal of Interventional Imaging and Therapy

基　　金：邢台市重点研发计划自筹项目(2023ZC061)。

摘　　要：目的观察骨骼肌指数(SMI)对肝细胞癌(HCC)患者经TACE后总生存期(OS)的影响。方法回顾性分析110例接受TACE的HCC患者,基于L3层面轴位CT图测算SMI,据此将其分为低SMI(L-SMI)组(n=91)及高SMI(H-SMI)组(n=19);绘制Kaplan-Meier生存曲线,并以log-rank检验进行组间比较;以单因素和多因素Cox比例风险回归模型评估HCC患者TACE后OS的影响因素。结果与H-SMI组相比,L-SMI组男性及HCC最大径>3cm者占比较高(P均<0.05)而血清白蛋白水平较低(P<0.05);随访期内L-SMI组总死亡率高于H-SMI组(P<0.05)。L-SMI组OS(中位OS 9个月)较H-SMI组(中位OS 19个月)缩短(P<0.05)。HCC最大径>3 cm、出现转移及L-SMI均为HCC患者TACE后OS相对缩短的独立危险因素(P均<0.05)。结论L-SMI与HCC患者TACE后OS相对缩短有关;利用CT测算SMI可为评估HCC患者经TACE后的预后提供客观依据。Objective To observe the impact of skeletal muscle index(SMI)on overall survival(OS)of hepatocellular carcinoma(HCC)patients after TACE.Methods Data of 110 HCC patients after TACE were retrospectively analyzed.SMI was calculated based on axial CT images at the level of L3,and the patients were divided into low SMI(L-SMI)group(n=91)and high SMI(H-SMI)group(n=19)according to SMI.Kaplan-Meier survival curves were drawn,and log-rank test was used for comparison of groups.Univariate and multivariate Cox proportional risk regression models were sequentially built to screen the impact factors of OS in HCC patients after TACE.Results The ratio of male and with HCC maximum diameter>3 cm were higher,but the serum albumin level was lower in L-SMI group than those in H-SMI group(all P<0.05).During the follow-up period,the total mortality rate in L-SMI group was higher than that in H-SMI group(P<0.05).OS of patients in L-SMI group(median OS 9 months)was shorter that in H-SMI group(median OS 19 months)(P<0.05).HCC maximum diameter>3 cm,occurrence of metastasis and L-SMI were all independent risk factors for relative shorten of OS in HCC patients after TACE(all P<0.05).Conclusion L-SMI was associated with the relative shorten of OS in HCC patients after TACE.SMI measured based on CT might provide objective evidences for evaluating prognosis of patients with HCC after TACE.

关 键 词：癌 肝细胞 化学栓塞 治疗性 体层摄影术 X线计算机 肌 骨骼 预后 

分 类 号：R735.7[医药卫生—肿瘤] R814.42[医药卫生—临床医学] R815